Effect of neuromuscular electrical stimulation and isotonic exercises in flexor and extensor muscles of knee of hemiplegic patients

Aim. To verify the muscular force and resistance to the movement of the flexor and extensor muscles of the knee of patients with spasticity after treatment with neuromuscular electrical stimulation (NMES) and isotonic exercises. Patients and methods. The patients this study were divided into group I (NMES) and group 2 (isotonic exercises). Their muscular torque and resistance to the movement of the flexor and extensor knee muscles were measured by the isokinetic dynamometer and the degree of spasticity by the modified Ashworth scale before and after ten sessions. Results. Alterations in the scores of the modified Ashworth scale were not observed. An increase in the flexor torque in group 1 (p = 0.041) and in group 2 (p = 0.001) was verified. In the passive mode, group 1 presented a reduction of resistance to the flexion movement (p = 0.026), while in group 2, a reduction of resistance to both the flexion (p = 0,029) and extension movements (p = 0.019) was verified. Conclusions. The two therapeutical resources had their efficiency proven only for the increase of the force of the flexor muscles. The resistance to movement, the isotonic exercises were more effective because they promoted a reduction in the resistance of the flexor and extensor knee muscles.

Liquid crystalline cellulosic elastomers: free standing anisotropic films under stretching

The structure and local ordering of 1,6-hexamethylenediisocyanate-(acetoxypropy1) cellulose (HDI-APC) liquid crystalline elastomer thin films are investigated by using X-ray diffraction and scattering techniques. Optical microscopy and mechanical essays are performed to complement the investigation. The study is performed in films subjected or not to an uniaxial stress. Our results indicate that the film is constituted by a bundle of helicoidal fiber-like structure, where the cellobiose block spins around the axis of the fiber, like a string-structure in a smectic-like packing, with the pitch defined by a smectic-like layer. The fibers are in average perpendicular to the smectic-like planes. Without the stretch, these bundles are warped, only with a residual orientation along the casting direction. The stretch orients the bundles along it, increasing the smectic-like and the nematic-like ordering of the fibers. Under stress, the network of molecules which connects the cellobiose blocs and forms the cellulosic matrix tends to organize their links in a hexagonal-like structure with lattice parameter commensurate to the smectic-like structure.

An algorithm for automatic checking of exercises in a dynamic geometry system: iGeom

One of the key issues in e-learning environments is the possibility of creating and evaluating exercises. However, the lack of tools supporting the authoring and automatic checking of exercises for specifics topics (e.g., geometry) drastically reduces advantages in the use of e-learning environments on a larger scale, as usually happens in Brazil. This paper describes an algorithm, and a tool based on it, designed for the authoring and automatic checking of geometry exercises. The algorithm dynamically compares the distances between the geometric objects of the student`s solution and the template`s solution, provided by the author of the exercise. Each solution is a geometric construction which is considered a function receiving geometric objects (input) and returning other geometric objects (output). Thus, for a given problem, if we know one function (construction) that solves the problem, we can compare it to any other function to check whether they are equivalent or not. Two functions are equivalent if, and only if, they have the same output when the same input is applied. If the student`s solution is equivalent to the template`s solution, then we consider the student`s solution as a correct solution. Our software utility provides both authoring and checking tools to work directly on the Internet, together with learning management systems. These tools are implemented using the dynamic geometry software, iGeom, which has been used in a geometry course since 2004 and has a successful track record in the classroom. Empowered with these new features, iGeom simplifies teachers` tasks, solves non-trivial problems in student solutions and helps to increase student motivation by providing feedback in real time. (c) 2008 Elsevier Ltd. All rights reserved.

Avaliação dos efeitos da reeducação postural global (rpg) em pacientes com espondilite anquilosante

The Ankylosing Spondylitis (AS) is a chronic inflammatory disease that primarily affects the axial skeleton, leading to limitation of spine mobility and functional disability. Physical therapy, especially exercise, is an important part in your treatment. The Global Postural Reeducation(GPR),a method that uses stretching based on evaluation of muscular chains, with significant interference in postural changes may be a complementary alternative for the treatment of this disease. The aim was to evaluate the effects of Global Postural Reeducation (GPR) in patients with Ankylosing Spondylitis (AS) and compare GPR with group conventional segmental self-stretching and breathing exercises. This is a controlled interventional study of 38 patients divided into 2 groups: a GPR group (n = 22) and a control group (n = 16). Both groups were treated over four months. With the GPR group patients, positions that stretched the shortened muscle chains were used. With the control group patients, conventional segmental self-stretching and breathing exercises were performed. The variables analyzed were: pain intensity, morning stiffness, spine mobility, chest expansion, functional capacity (Health Assessment Questionnaire - Spondyloarthropathies - HAQ-S), quality of life (Medical Outcome Study Short Form 36 Healthy Survey-SF-36), and disease activity (Bath Ankylosing Spondylitis Disease Activity Index - BASDAI). Statistical analysis was used with a significance level of p < 0.05. There was a statistically significant difference for all the parameters analyzed between pre and post-treatment in both groups. In the inter-group comparison the GPR group showed a statistically significant improvement in morning stiffness (p = 0.01), spine mobility parameters, except finger-floor distance (p = 0.11), in chest expansion (p = 0.02), and in the physical aspect component of the SF-36 (p = 0.00).Finally, we observed that this sample of patients with AS ,treatment with RPG 60 seems to have a better response in some clinical measures, than the conventional self stretching performed in groups. Further studies are needed to further evaluate this therapeutic alternative in the EA

Analysis of the Coupled Stretching-Bending Problem of Stiffened Plates by a BEM Formulation Based on Reissner's Hypothesis

In this work, the plate bending formulation of the boundary element method - BEM, based on the Reissner's hypothesis, is extended to the analysis of plates reinforced by beams taking into account the membrane effects. The formulation is derived by assuming a zoned body where each sub-region defines a beam or a slab and all of them are represented by a chosen reference surface. Equilibrium and compatibility conditions are automatically imposed by the integral equations, which treat this composed structure as a single body. In order to reduce the number of degrees of freedom, the problem values defined on the interfaces are written in terms of their values on the beam axis. Initially are derived separated equations for the bending and stretching problems, but in the final system of equations the two problems are coupled and can not be treated separately. Finally are presented some numerical examples whose analytical results are known to show the accuracy of the proposed model.

A BEM formulation for analysing the coupled stretching-bending problem of plates reinforced by rectangular beams with columns defined in the domain

In this work, a boundary element formulation to analyse plates reinforced by rectangular beams, with columns defined in the domain is proposed. The model is based on Kirchhoff hypothesis and the beams are not required to be displayed over the plate surface, therefore eccentricity effects are taken into account. The presented boundary element method formulation is derived by applying the reciprocity theorem to zoned plates, where beams are treated as thin sub-regions with larger rigidities. The integral representations derived for this complex structural element consider the bending and stretching effects of both structural elements working together. The standard equilibrium and compatibility conditions along interface are naturally imposed, being the bending tractions eliminated along interfaces. The in-plane tractions and the bending and in-plane displacements are approximated along the beam width, reducing the number of degrees of freedom. The columns are introduced into the formulation by considering domain points where tractions can be prescribed. Some examples are then shown to illustrate the accuracy of the formulation, comparing the obtained results with other numerical solutions.

Torque, myoeletric sygnal and heart rate responses during concentric and eccentric exercises in older men

Background: The literature reports that the eccentric muscular action produces greater force and lower myoelectric activity than the concentric muscular action, while the heart rate (HR) responses are bigger during concentric contraction. Objectives: To investigate the maximum average torque (MAT), surface electromyographic (SEMG) and the heart rate (HR) responses during different types of muscular contraction and angular velocities in older men. Methods: Twelve healthy men (61.7 +/- 1.6years) performed concentric (C) and eccentric (E) isokinetic knee extension-flexion at 60 degrees/s and 120 degrees/s. SEMG activity was recorded from vastus lateralis muscle and normalized by Root Mean Square-RMS (mu V) of maximal isometric knee extension at 60 degrees. HR (beats/min) and was recorded at rest and throughout each contraction. The data were analyzed by the Friedman test for repeated measures with post hoc Dunn's test (p<0.05). Results: The median values of MAT (N.m/kg) was smaller and the RMS (mu V) was larger during concentric contraction (C60 degrees/s=2.80 and 0.99; C120 degrees/s=2.46 and 1.0) than eccentric (E60 degrees/s=3.94 and 0.85; E120 degrees/s=4.08 and 0.89), respectively. The HR variation was similar in the four conditions studied. Conclusion: The magnitude of MAT and RMS responses in older men were dependent of the nature of the muscular action and independent of the angular velocity, whereas HR response was not influenced by these factors.

Temporomandibular Joint Vibration Before and After Exercises and Occlusal Splints

Temporomandibular joint (TMJ) sounds are frequent in patients. The aim of this study was to analyze patients with clicking at the end of opening and at the beginning of closing their mouths treated by muscular exercises through chewing and by occlusal splints. Fifteen patients with clinically verified clicking and TMJ and 15 patients without sounds were selected by the Research Diagnostic Criteria for Temporomandibular Disorders. They were submitted to electrovibratography at consultation and 60 and 120 days of treatment by occlusal splints and exercises. Patients demonstrated significant reduction of TMJ sounds after treatment, but vibration intensity was not similar with that of the control group after 120 days.

Morphology and protein content of hepatocytes in type I diabetic rats submitted to physical exercises

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Electromyographic activity of shoulder muscles during exercises performed with oscillatory and non-oscillatory poles

CONTEXTUALIZAÇÃO: A dor e a disfunção no complexo articular do ombro é comumente encontrada na prática fisioterapêutica. Essas anormalidades musculoesqueléticas estão relacionadas à instabilidade e inadequado funcionamento cinemático, que dependem da integridade dos tecidos musculares. Assim, no sentido de prevenir e reabilitar esses sintomas, o uso da haste oscilatória vem sendo implantado para melhorar os resultados de técnicas cinesioterapêuticas. OBJETIVOS: Analisar a atividade eletromiográfica (EMG) dos músculos que estabilizam a articulação do ombro durante a realização de exercícios com haste oscilatória e haste não-oscilatória. MÉTODOS: Participaram do estudo 12 voluntárias com idade de 20,4±1,9 anos. Os dados EMG foram coletados nos músculos trapézio superior (TrS), trapézio inferior (TrI) e deltoide médio (DM) durante três diferentes exercícios realizados com haste oscilatória e haste não-oscilatória. O sinal EMG foi analisado no domínio do tempo pelo cálculo do Root Mean Square (RMS). Os valores de RMS foram normalizados pelo valor de pico obtido em todas as tentativas por cada músculo. A análise estatística foi feita com os testes ANOVA para medidas repetidas e post-hoc de Bonferroni. RESULTADOS: A atividade EMG dos músculos TrS, TrI e DM foi significativamente maior nos exercícios com haste oscilatória do que com haste não-oscilatória (todos p<0,001). Não foram significativas as diferenças na ativação desses músculos entre os exercícios. CONCLUSÃO: Os resultados do presente estudo indicaram que a haste oscilatória requisitou maior atividade EMG dos músculos do ombro e, assim, pode ser um instrumento útil no treinamento desses músculos.

Stress biomarkers in rats submitted to swimming and treadmill running exercises

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Electromyographic activity of trunk muscles during exercises with flexible and non-flexible poles

Objective: Hand-held flexible poles which are brought into oscillation to cause alternating forces on trunk, are advocated as training devices that are supposed to solicit increased levels of stabilizing trunk muscle activity. The aim of this study was to verify this claim by comparing electromyographic (EMG) activity of trunk muscles during exercises performed with a flexible pole and a rigid pole.Methods: Twelve healthy females performed three different exercises with flexible and rigid poles. EMG activity of iliocostalis lumborum (IL), multifidus (MU), rectus abdominis (RA), external oblique (EO) and internal oblique (IO), and was continuously measured. The EMG signals were analyzed in time domain by calculation of the Root Mean Square (RMS) amplitudes over 250 ms windows. The mean RMS-values over time were normalized by the maximum RMS obtained for each muscle.Results: The IO showed a 72% greater EMG activity during the exercises performed with the flexible pole than with the rigid pole (p = 0.035). In exercises performed in standing, the IO was significantly more active than when sitting (p = 0.006).Conclusion: As intended, the cyclic forces induced by the oscillating pole did increase trunk muscle activation. However, the effect was limited and significant for the IO muscle only.

Terapia manual no tratamento da espondilólise e espondilolistese: revisão de literatura

A espondilólise é um defeito na pars interarticularis da vértebra com descontinuidade óssea do segmento intervertebral; a progressão do defeito resulta em deslizamento de uma vértebra sobre a outra, chamado espondilolistese, o que pode provocar dor. O tratamento não-cirúrgico é a escolha inicial na maioria dos casos de espondilolistese, mas poucos estudos verificam a eficácia dos tratamentos conservadores. O objetivo deste estudo foi realizar uma revisão da literatura sobre esses tratamentos, sobretudo no que concerne à terapia manual, a fim de ajudar os terapeutas na prescrição de intervenções eficazes. Os resultados mostram que tanto a terapia manual como a fisioterapia convencional apresentam efeitos benéficos na redução da dor lombar e na melhora funcional do paciente. As terapias manuais envolvem manipulação da coluna vertebral e articulação sacroilíaca, músculo-energia e alongamento dos músculos afetados. Exercícios de estabilização lombopélvica, fortalecimento dos músculos posturais e alongamento dos isquiotibiais e psoas também foram considerados importantes. O paciente deve ser avaliado individualmente em seu quadro clínico e radiográfico para determinação do plano de tratamento. Dentre as opções conservadoras de tratamento encontradas, nenhuma se mostrou conclusivamente superior às outras e todas podem ser incluídas no tratamento sintomático de pacientes com espondilólise/listese.